Heart function

[Jbuhlman]

I`ve had heart trouble all of my life. With the help of medication I have lead a pretty good life. But recently in September an Echo showed a decrease of 12% in heart function. There were no other signs for this. No increase in gradient, or any type of blockage. Everything looked fine except for the loss of function. I have been taking an ACE inhibitor, but have not seen an improvement. I can feel the decrease in function.It makes me slow and very very tired. Its difficult to do everyday chores, especially going to work. 6 months ago I had tons of energy, now very little. I`m seeing a specialist tomorrow in Halifax, NS again. Hoping to get another approach. Is there anything or anyway at all for me to feel better? Thank you so much.

[Jbuhlman]

I have had some blood work,but not sure if I was tested for electrolytes or hyperthyroidism. I do take an ACE inhibitor called Coversyl. I would like to say that it is helping, but I`m not sure on that one either. A few weeks back my pharmacist told me i could be on too much Sotalol and that would explain some of my symptoms. So this past Wednesday I was in Halifax to see the doc again. He told me to increase the ACE and decrease my Beta blocker. So, we`ll go from there. Thank you guys again. Its really nice to have some people to talk to and who understand.

[banglamom]

40% is not good, but... you still have a buffer.  When I first got sick, my EF was 70%!  I at least know WHY as to the decline in function.  For you, the cardiologist HAS to figure it out.  That is the way to prevent further problems.  After a few years, it had gone to 60.. no problem.. several years later, it was at 50.  Two years ago, it dropped to 40 and I agree, it is just not the same as 50-60.  I get WORN out.   I was 39 and with 2 little kids.  You NEED to be on the ACE inhibitors for sure.  At very least, if the ACE hasn't made you better, maybe it has at least made the decline slower than it would have been otherwise.  There is no way to know for sure, but research indicates it makes a significant (statistically) impact.  Have you been on Coreg?  Anything else?  Talk to your doc about every little thing that might help and reach far and wide.  Take cardiac vits, take CoQ10, take fish oil.  They won't hurt and they MAY help according to both research and anecdotal information.  That is what we HAVE to do.  If my md told me, just 2 cans of ALPO a day... I might be willing to try it.  By all means, don't SMOKE.  When I got to 40% ( which slowly arrived with all the valves leaking and the conduction in absolute shambles), I felt like I was on a ledge.  

I'll wait to tell you more after they tell you options at the md.  There are still options and on this forum, you will find people who have had about every test and every intervention.  We will cheerlead you through and ( even if only electronically) hold your hand.  I have been on here for just a few weeks and find it encouraging and hopeful.  Keep in touch.

[kenkeith]

Has a blood test indicated electrolytic balance, etc. and has hyperthyroidism been ruled out.  The conditions can account for arrhythmia (tachy cardio) and other problems..

[Jbuhlman]

That was my problem as a kid. The dimensions would have to be watched carefully and i was on Rythmodan for that. Then in 1996, for some reason, the meds were not working and the dimensions increased. Sending my heart rate to over 200 bpm at times. But this time all dimensions look good. No increase at all. Maybe in some way my body isnt using the Sotalol as it should. Thank you to both of you for replying.

[Jbuhlman]

This time a few years ago it was at 52%, now its down to 40% and I`m feeling really tired and weak. My energy runs out very quickly. I have been talking Sotalol for the past 12 years. 120mg twice daily.

[kenkeith]

Usually, with a heart condtion and diminished EF, the cause is an increase in the left ventricle diminsions.  The enlarged LV (dilated) is oftened caused by the stress of the heart pumping against high resistance due to constricted vessels.  An ACE inhibitor dilates vessels and provides relief for the heart and sometimes the heart reverses remodeling (returns to normal size) and EF returns to normal.  It may take additional time, how well other parts of the system compensates, proper diet, lifestyle, etc.

An echo is an ESTIMATE of the EF.  Below 29% EF (amount of blood pumped with each stroke) is considered heart failure mode (supply not meeting demand for blood/oxygen)  There are about 26% of the heart disorder population in the heart failure range that do not have any symptoms and feel well!  And then there are individuals that don't feel well when the EF is just below the normal 50 EF.  How you feel may not be due to contractility problem.  

Are the dimensions estimated on your Echo within the normal range?

[banglamom]

12% lower than what?  Generally at 35-50%, it is time to watch and intervene medically where possible.  At 25%, people are getting signed on the transplant list.  People with <20% EF or basically GRAVELY disabled from cardiac function.  I have seen both professionally and experientially that when the EF decreases slowly over time, it is tolerated better than when people lose it all at once.  Those people who have a heart attack, ie... and instantly lose functions have no time to compensate like those who have more slowly reached the same ejection fraction.